Registration
Standard First Aid and CPR C re-certification course.
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
Email: (Emails are kept confidential)
 
Address: *
City: * State/Prov: * Postal Code: *
Emergency Contact Info
(Not Contact #1 or #2)
 
 
Students entered below will be added to your family's account
 
Questions/Options:
LSS ID? *
Have you Re-Certified your SFA before? Was the last time you did, a full course or a re-cert?*
Favourite Snack food? Simon might make it happen during the course? *
 
Additional Information:
 
Medical Conditions
Individuals with serious medical conditions or developmental disabilities should be accompanied at all times by another individual with knowledge of their condition and who can provide immediate assistance if needed.
I've read the above and agree.
 
Release
Releases Oakville Swim Academy and all of its associated companies, including but not limited to 1975106 Ontario Inc., and all affiliates, successors, directors and officers and heirs thereof, and/or the facility at which the student(s) attend lessons and/or events from all claims and liabilities whatsoever arising from participation in or attendance at one or more of Oakville Swim Academy's current or future programs by the undersigned, the undersigned's child(ren) or any associated spectator(s).
I've read the above and agree.
 
Cancellation Policy
Students that withdraw up until Dec 30th can receive a full refund, after Dec 30 will be refunded minus a $20.00 Fee
I've read the above and agree.
 
Information Accuracy
Acknowledges that the information on this Registration Form is true and correct.
I've read the above and agree.
 
Event Cancellation
If fewer than 3 people sign up for the class by Dec 30th, you will be notified.
I've read the above and agree.
 
Payment
When you register you will be asked to have your card on file. Charges will not occur until Jan 1 after we have confirmed that there are enough students enrolled.
I've read the above and agree.
 
Enter your Full Name: *   
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number:  
Name as it appears on card:
Nickname:
Card Expiration Month:   Exp Year:
Address Line 1: Address Line 2:
City: State/Prov: Postal Code: